| NPI | 1710303045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ME PS1061) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 003331-1) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2016-10-07 |