| NPI | 1265742183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 018881) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY 9165) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2020-04-10 |