| NPI | 1861845018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MN 64134) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME LC13096) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 64134) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 28402) | |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2024-01-19 |