| NPI | 1649378258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 175058) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: RI PS00608) |
| 103T00000X Psychologist (Licence: MA 6311) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-08-30 |