| NPI | 1689960411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 016990) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1725) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2013-04-26 |