| NPI | 1962939827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 023428) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 023428) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2020-11-13 |