| NPI | 1164200424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810007774) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 027241-01) |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2025-05-23 |