| NPI | 1164403499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 024403) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 2387) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2021-08-17 |