| NPI | 1700288073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10648) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 05716) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2019-04-13 |