| NPI | 1023205523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 017263) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 68 017263) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2022-03-17 |