| NPI | 1104130350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04978) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY P73229) |
| 103TC0700X Psychologist, Clinical (Licence: DC PSY1000683) | |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2013-08-03 |