| NPI | 1366929549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 022609-1) |
| Additional Taxonomies | 103TR0400X Psychologist Rehabilitation (Licence: NY 022609-1) |
| 103TP2701X Psychologist Group Psychotherapy (Licence: NY 022609-1) | |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2018-07-20 |