| NPI | 1770070393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA MA11431) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: RI PS02148) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2024-08-06 |