| NPI | 1710275342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: NY 70647071) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: NY 482390101) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2011-07-18 |