| NPI | 1528078664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 012331) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: NY 012331) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-10 |