| NPI | 1912496852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 9555) |
| 103T00000X Psychologist (Licence: NH 1410) | |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2018-05-14 |