| NPI | 1063051738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 3898) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 023586) |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2022-11-03 |