| NPI | 1245512151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 015979) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 002903) |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2011-09-16 |