| NPI | 1720122120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NY 017882) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MO 2006033337) |
| Enumeration Date | 2007-02-18 |
| Last Update Date | 2009-07-06 |