NPI | 1699177501 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 68 021865) |
Additional Taxonomies | 101Y00000X Counselor |
103TC0700X Psychologist, Clinical (Licence: IL 071.011188) | |
Enumeration Date | 2014-09-23 |
Last Update Date | 2025-08-21 |