| NPI | 1801323571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 023400) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KY 130323) |
| 103TC0700X Psychologist Clinical (Licence: OH 6379) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2020-04-29 |