| NPI | 1710276639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY7172) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 008928-1) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2011-03-31 |