| NPI | 1366975062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 023278-01) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 23278) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2023-06-30 |