| NPI | 1215262084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 68 018269) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 03-845068) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2016-12-28 |