| NPI | 1609443522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 025126) |
| 103TC0700X Psychologist, Clinical (Licence: CT 4554) | |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2024-03-13 |