| NPI | 1629324694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 3562) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 68 020159) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2016-05-24 |