| NPI | 1467849455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 021200) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NM 1372) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2020-04-14 |