| NPI | 1619673191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA PSY10000700) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: RI PS02151) |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2024-09-19 |