| NPI | 1790827848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 0131611-1) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 3787) |
| 103TC0700X Psychologist, Clinical (Licence: CA 21124) | |
| 103TC0700X Psychologist, Clinical (Licence: TX 24091) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |