| NPI | 1588278550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA PSY50000441) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 003967) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 3967) | |
| Enumeration Date | 2020-09-07 |
| Last Update Date | 2024-01-02 |