| NPI | 1235488891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 8627) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 019694) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2021-10-22 |