| NPI | 1639742554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3994) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 024765) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2025-04-10 |