| NPI | 1649449505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 2342) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 17200) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2008-02-25 |