| NPI | 1316002397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 0176141) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: GA PSY002697) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2017-12-21 |