| NPI | 1013376342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 021518) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810005312) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-07-14 |