| NPI | 1578112157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 026704) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 009141) |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2024-10-08 |