| NPI | 1023479219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 023886) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 003817) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2022-04-17 |