| NPI | 1770153975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 025012) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NJ 6705) |
| 103T00000X Psychologist (Licence: PA PSO19264) | |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2022-08-15 |