| NPI | 1912308461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 4029) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 020639) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2024-11-07 |