| NPI | 1902010440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 019713) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 001743) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-10-05 |