| NPI | 1093115354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 4611) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 020094) |
| Enumeration Date | 2014-08-23 |
| Last Update Date | 2014-10-21 |