| NPI | 1689245664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: 091532) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 091532) |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2021-07-09 |