| NPI | 1669677050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9213) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 9213) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9213) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2022-10-05 |