| NPI | 1184172546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: NY 020236) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 020236) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2017-03-09 |