| NPI | 1760919203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 0004848) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 021619) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2024-05-10 |