| NPI | 1376521294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS015413) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 023261) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2019-07-30 |