| NPI | 1689233702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11564) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: RI PS01813) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2021-09-01 |