| NPI | 1659501153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: NY 1209012) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 1209012) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2009-07-17 |