| NPI | 1487918660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 003696) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 021811) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2022-02-06 |