| NPI | 1225178775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VT 048-0000511) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 009317) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-08 |