| NPI | 1023417979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005060) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 68 017099) |
| Enumeration Date | 2014-08-16 |
| Last Update Date | 2014-08-17 |