| NPI | 1760954606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11753) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2022-04-06 |