| NPI | 1114299062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: DC 1000627) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019300) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2016-09-06 |