| NPI | 1316495419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810007783) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 020764) |
| Enumeration Date | 2016-09-17 |
| Last Update Date | 2022-11-21 |