| NPI | 1578948493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: RI PS01432) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 10710) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2018-07-19 |