| NPI | 1215260575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 3318) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019218) |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2018-06-11 |