| NPI | 1558751016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS017921) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 021209) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2017-12-27 |