| NPI | 1194707364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3073) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 014585) |
| 103TC0700X Psychologist, Clinical (Licence: MD 03883) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2009-01-29 |