| NPI | 1205508751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS019965) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 025424) |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2025-05-28 |