| NPI | 1811306194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10059) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: 10059) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2015-01-24 |