| NPI | 1831598093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: RI PS01459) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01459) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2015-10-19 |