| NPI | 1023412855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2014035929) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 020441) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |