| NPI | 1912197211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10165) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01138) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2015-08-04 |