NPI | 1396201737 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 07045) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 023079) |
Enumeration Date | 2019-02-11 |
Last Update Date | 2023-08-15 |