| NPI | 1992473961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 025315) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CT 4503) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2024-07-18 |