| NPI | 1861633406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9759) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 017184-1) |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2013-11-26 |