| NPI | 1538230651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 1652) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 014487-1) |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2016-04-05 |