| NPI | 1629567110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 024151) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11389) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2021-09-08 |