| NPI | 1861137184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS020055) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 024828) |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2024-01-22 |