| NPI | 1962515676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 6020) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MA 6020) |
| 103TC0700X Psychologist, Clinical (Licence: MA 6020) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2017-03-30 |