| NPI | 1548770332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 11576) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: ME PS1484) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2021-09-27 |