| NPI | 1689721391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 7695) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 310307) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2019-11-01 |