| NPI | 1538231618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004199) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 018112) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2012-04-25 |