| NPI | 1922685601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 6485) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 024118-01) |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2024-04-11 |