| NPI | 1720169527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 008021) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL py0003532) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2015-01-15 |