| NPI | 1689034506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 013905) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VT 48.0115459) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-03-04 |