| NPI | 1649364134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 006126-1) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: NY 6126) |
| 103TC0700X Psychologist, Clinical (Licence: NY 6126) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |