| NPI | 1649768854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005985) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 022216) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2020-03-02 |