| NPI | 1659142040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 29049) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TF0000X Psychologist, Family | |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |