| NPI | 1770161705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA PSY10000482) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA PSY10000482) |
| 103TH0004X Psychologist, Health (Licence: MA PSY10000482) | |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2024-04-04 |