| NPI | 1992903017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY0003469) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 013351) |
| 103TC0700X Psychologist, Clinical (Licence: NY 013351) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2022-07-21 |