| NPI | 1598047227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 05469) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NH 1271) |
| 103TC0700X Psychologist Clinical (Licence: NY 020033) | |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2020-11-17 |