| NPI | 1609768233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA PSY10001926) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service |
| Enumeration Date | 2025-07-17 |
| Last Update Date | 2025-09-26 |