| NPI | 1598499915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 003700) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 017311-1) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 017311-1) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CT 003700) | |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-12 |