| NPI | 1396197356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC 1657) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 021648-1) |
| 103TC0700X Psychologist, Clinical (Licence: MA 10929) | |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2021-10-22 |