| NPI | 1700241130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10496) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 019290) |
| 103TC0700X Psychologist, Clinical (Licence: NY 019290) | |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2022-07-15 |