| NPI | 1215973425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8115) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 015925-1) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-06-13 |