| NPI | 1679870505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 019708) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 9302) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2024-05-22 |