| NPI | 1164609665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 9226522-2501) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 017071) |
| 103TC0700X Psychologist, Clinical (Licence: NJ 5088) | |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2016-11-04 |