| NPI | 1245647965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 3604) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 020668) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2017-10-25 |