| NPI | 1427191394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 012112) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 3286) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2016-11-11 |