| NPI | 1972757821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9194) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 002890) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2019-04-09 |