| NPI | 1629454822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS018335) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ME PS1324) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2019-08-19 |