| NPI | 1942660600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 3106) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 018956) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2020-03-21 |