| NPI | 1982817276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 8740) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: RI PS00971) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2018-05-11 |