| NPI | 1548374457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 6251) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 010115-1) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2015-10-06 |