| NPI | 1821042185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 8443) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NH 1120) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2017-02-10 |