| NPI | 1043668072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: DC 1000710) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 018039) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-08-25 |