| NPI | 1356698450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9498) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 018924) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |