| NPI | 1699798298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 9788) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 9788) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-03-08 |