| NPI | 1780812404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 016711-1) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 3979) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2009-07-01 |