| NPI | 1972066298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11636) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA PSY11636) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2025-01-02 |