| NPI | 1376644211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 001641) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 010267) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2023-09-18 |