| NPI | 1225383821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 019643) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019643) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2016-02-26 |