| NPI | 1932242344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 006698-1) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 3207) |
| 103T00000X Psychologist (Licence: NY 006698-1) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2018-03-15 |