| NPI | 1578867263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9300) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 020482-1) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2015-04-13 |