| NPI | 1578556882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 1312) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 15004) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2018-05-24 |