| NPI | 1730474743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 016418) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 016418) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2022-10-04 |