| NPI | 1962912386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 05757) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810005843) |
| 103TC0700X Psychologist Clinical (Licence: NY 025085) | |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2025-01-31 |