| NPI | 1174153761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS018995) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 023455) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-05-27 |