| NPI | 1770857773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 019505) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 9453) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-08 |