| NPI | 1164513313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 013817) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY11588) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2024-06-03 |