| NPI | 1063836500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 020428-1) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 020428-1) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: NY 020428-1) | |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2021-05-13 |