| NPI | 1124318860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 7617494) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NM 1171) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2016-03-07 |