| NPI | 1063414423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 016059) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 016059-1) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2015-12-10 |