NPI | 1790194942 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11073) |
Additional Taxonomies | 103TF0000X Psychologist, Family |
103TC2200X Psychologist, Clinical Child & Adolescent | |
Enumeration Date | 2014-08-12 |
Last Update Date | 2021-05-10 |