| NPI | 1063085561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10176) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 023140) |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2021-07-21 |