| NPI | 1174098875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS018334) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 021926-1) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2019-01-02 |