| NPI | 1699193672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 2683) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 008026) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2018-02-27 |