| NPI | 1497025340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 019779) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA ps017156) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2013-05-02 |