| NPI | 1477739381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 001912) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 011616-1) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2008-01-10 |