| NPI | 1720010218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 017628) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VT 048-0000705) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-08-10 |