| NPI | 1477238392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 025773) |
| Additional Taxonomies | 103TH0004X Psychologist, Health |
| 103TC0700X Psychologist, Clinical (Licence: NY 025773) | |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2023-06-19 |