| NPI | 1740557545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1186) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 018678) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2014-11-12 |