| NPI | 1679040364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10935) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS1736) |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2018-10-31 |