| NPI | 1629135785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 002676) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 011111) |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2007-07-08 |