| NPI | 1790040046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 019598) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019598) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2021-10-06 |