| NPI | 1255885125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11424) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 021743) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2022-03-07 |