| NPI | 1376709386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS016480) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 017612) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2022-08-31 |