| NPI | 1114504875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 105430) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2025-04-03 |