| NPI | 1770720732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 018103) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: NY 018103) |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2010-08-21 |