| NPI | 1295165546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9029) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 017858) |
| Enumeration Date | 2013-11-23 |
| Last Update Date | 2014-05-29 |