| NPI | 1639505845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 3320) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 020274) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2017-09-27 |