| NPI | 1164643912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 001997) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 007625-1) |
| 103TF0000X Psychologist, Family (Licence: CT 001997) | |
| 103TF0000X Psychologist, Family (Licence: NY 007625-1) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |