| NPI | 1750779005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 10151) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 020950) |
| 103TC0700X Psychologist Clinical (Licence: CT 003865) | |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2020-11-04 |