| NPI | 1457374001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 3340) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 013115) |
| 103T00000X Psychologist (Licence: PR 3340) | |
| 103TC0700X Psychologist, Clinical (Licence: NY 013115-1) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2017-03-01 |