NPI | 1578173043 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 027403) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810008555) |
Enumeration Date | 2020-08-08 |
Last Update Date | 2025-09-05 |