| NPI | 1639378672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3628) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 017140) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2014-08-11 |