| NPI | 1891879920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 000824) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 0063481) |
| 103TC0700X Psychologist, Clinical (Licence: MA 2419) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-05-05 |