| NPI | 1013460252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 002020) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 010431-1) |
| Enumeration Date | 2016-07-23 |
| Last Update Date | 2016-07-23 |