| NPI | 1770141319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY10000636) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 283207) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071010042) | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2024-11-13 |