| NPI | 1447353859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 001926) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 012283) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2007-07-08 |