| NPI | 1417146309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 019278) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 04357) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2012-03-06 |