| NPI | 1689930182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9193) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 9193) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2015-03-03 |