| NPI | 1366712432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 012326-1) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: NY 461486931) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |