| NPI | 1659737179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MA 6843) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: RI PS00550) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |