| NPI | 1194161398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017378) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 019973) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2013-05-14 |