| NPI | 1942693601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 3304) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 019811) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2021-04-01 |