| NPI | 1659973246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11390) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01899) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2021-01-29 |