| NPI | 1720091259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810003920) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 016335-1) |
| 103TC0700X Psychologist, Clinical (Licence: NY 016335) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2021-08-30 |