| NPI | 1306834007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VT 048.0062817) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 010838) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2013-05-16 |