| NPI | 1407989791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WI 2719-057) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IA 613) |
| 103TC0700X Psychologist Clinical (Licence: NY 15823) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2010-11-18 |