NPI | 1578188694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NY 025254) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA 34048) |
103TC0700X Psychologist, Clinical (Licence: NY 025254) | |
103TC0700X Psychologist, Clinical (Licence: CA 34048) | |
Enumeration Date | 2020-06-15 |
Last Update Date | 2024-04-02 |