| NPI | 1710498480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: NY 026825) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 026825) |
| 106H00000X Marriage & Family Therapist (Licence: IL 166.001165) | |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2025-01-16 |