| NPI | 1518956721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 16580) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 10440) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2007-07-08 |