| NPI | 1699095539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11209) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NH 1259) |
| 103TC0700X Psychologist, Clinical (Licence: ME PS1543) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2020-03-17 |