| NPI | 1851816268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 10629) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 10639) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2023-02-03 |