| NPI | 1811359029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10406) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 003506) |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2016-11-07 |