| NPI | 1720606718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY10868) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist Clinical (Licence: NY 024170-01) | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2023-08-14 |