| NPI | 1679020887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 021977) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY P01472) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2024-05-10 |