| NPI | 1174839005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 003086) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 68018722) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2011-10-04 |