| NPI | 1578014890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 11865) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 022570) |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2024-11-18 |