| NPI | 1225380918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS018199) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 019817) |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2017-02-03 |