| NPI | 1174874879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 019372) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019372-1) |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2021-11-23 |