| NPI | 1760418180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3613) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 011228-1) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2014-01-23 |