| NPI | 1972650703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VT 443) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NH 582) |
| 103TC0700X Psychologist Clinical (Licence: VT 443) | |
| 103TC0700X Psychologist Clinical (Licence: NH 582) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |