| NPI | 1740631563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 021682) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 37202) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2020-04-06 |