| NPI | 1609206986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 023588) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 11226) |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2019-12-20 |