| NPI | 1881879575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 7895) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS00751) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810002712) | |
| Enumeration Date | 2008-01-01 |
| Last Update Date | 2008-01-01 |