| NPI | 1528552619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: MA 9004-PY-PR) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9004-PY-PR) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2018-06-21 |