| NPI | 1649318106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 8104) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 8104) |
| Enumeration Date | 2007-02-04 |
| Last Update Date | 2012-12-20 |