| NPI | 1902189814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: RI 01434) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103T00000X Psychologist (Licence: MA 111256) | |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2021-11-18 |