| NPI | 1871998807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY11327) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: RI PS01744) |
| 103T00000X Psychologist (Licence: RI PS01744) | |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2024-12-13 |