| NPI | 1750049920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 024948) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 0005576) |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2023-09-15 |