| NPI | 1629008958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 001139) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 014502-1) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2013-09-04 |