NPI | 1407589914 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 025014) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 4238) |
Enumeration Date | 2022-07-03 |
Last Update Date | 2022-07-03 |