| NPI | 1720371180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NE 777) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 013712) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2018-09-19 |