| NPI | 1578889473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 017931) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810003996) |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2010-04-16 |