| NPI | 1902107196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 10882) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2024-08-01 |