| NPI | 1639233992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 016701) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY8148) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2010-10-01 |