| NPI | 1093111528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 020982) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: GA 003818) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2014-12-22 |