| NPI | 1093741696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 003486) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 016685) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2024-11-08 |