| NPI | 1780068254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 10120) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 020847) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2017-01-23 |