| NPI | 1174533707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2686-57) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 015104) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2013-09-10 |