| NPI | 1154638807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2758) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019491) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2016-10-21 |