| NPI | 1104043777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY9356) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 017084) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2023-05-15 |