| NPI | 1588021133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 3158) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NH 424) |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2016-01-26 |