| NPI | 1568909851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VT 048.0059118) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ME PS1469) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2021-02-11 |