| NPI | 1639179922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE BI0000558) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 013188) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2007-07-08 |