NPI | 1124571575 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 022240) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00675700) |
Enumeration Date | 2016-08-02 |
Last Update Date | 2022-09-29 |