| NPI | 1275978462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 023188-1) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 36122) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2019-07-01 |