| NPI | 1306992532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS015912) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 016434) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2008-10-20 |