| NPI | 1164998902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 020550-1) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 020550) |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2018-11-05 |