| NPI | 1578015673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS019647) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 022735) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2022-09-15 |