| NPI | 1780891960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 015935-1) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 002109) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |