| NPI | 1134548308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 025323) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 003750) |
| 101YM0800X Counselor Mental Health (Licence: NY 025323) | |
| 103TC0700X Psychologist Clinical (Licence: NY 025323) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2023-04-27 |