| NPI | 1053038844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 6650) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: NC 6650) |
| 103T00000X Psychologist (Licence: NY 026093) | |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2024-10-21 |