| NPI | 1205939493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 008198) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 008198) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2009-06-02 |