| NPI | 1083976690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 027216) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2012-06-10 |
| Last Update Date | 2025-05-16 |