| NPI | 1982139564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: MA 10950) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 10950) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MA 10950) | |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2019-12-19 |