| NPI | 1790321644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 3894) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CT 3894) |
| 103TC0700X Psychologist, Clinical (Licence: MA PSY11810) | |
| 103TS0200X Psychologist, School (Licence: CT 3894) | |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2023-10-12 |