| NPI | 1174247381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 4294) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 025146) |
| Enumeration Date | 2022-09-30 |
| Last Update Date | 2022-09-30 |