| NPI | 1245839109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY P107392) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY P107392) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-12-16 |