| NPI | 1366745192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 68021637) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TH0004X Psychologist, Health | |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2022-07-21 |