| NPI | 1760711147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PSO18007) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 020616) |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2021-02-16 |