| NPI | 1871856484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: RI PS01438) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: RI PS01438) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: RI PS01438) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2023-02-07 |