| NPI | 1063012318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 023947) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 4204) |
| 103T00000X Psychologist (Licence: RI PS01914) | |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2024-03-25 |