| NPI | 1679145817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY10000495) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2025-04-09 |