| NPI | 1093111619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3991) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 020493) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2014-11-10 |