| NPI | 1710351689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 020816) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS017915) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |