| NPI | 1700408705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS019693) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 025101) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2022-10-04 |