| NPI | 1720453434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 002835) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 016376-1) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |