| NPI | 1528460086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 004960) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 022084) |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2019-03-22 |