| NPI | 1619373982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 019718) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0005635) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2021-11-24 |