| NPI | 1750621413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY 8823) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 019990) |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2015-03-31 |