| NPI | 1821282807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 05339) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MD 05339) | |
| 103TC0700X Psychologist Clinical (Licence: NY 019895) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MD 05339) | |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2024-02-28 |