| NPI | 1841672805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10177) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 10177) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 10177) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2024-02-27 |