| NPI | 1104067149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005763) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 021540-1) |
| Enumeration Date | 2009-03-22 |
| Last Update Date | 2021-11-08 |