| NPI | 1730787755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 3270) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 023901) |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2023-07-25 |