| NPI | 1871991133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 301632) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NY 301632) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2023-05-04 |