| NPI | 1912310327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 021178) |
| Additional Taxonomies | 171W00000X Contractor (Licence: NY 021178) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2021-12-16 |