| NPI | 1255626156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY NY022550) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS016778) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2019-05-17 |