| NPI | 1154701639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017673) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS017673) |
| 103TC0700X Psychologist, Clinical (Licence: NY 021369) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: PA PS017673) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NY 021369) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2022-11-21 |