| NPI | 1205506672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 025216) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 111939-01) |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2023-06-22 |