| NPI | 1962116640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: RI PS02255) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA PSY10001624) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2025-10-14 |