| NPI | 1902187131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9848) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019252) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2020-09-29 |