| NPI | 1811012669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NY 016988) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 016988) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2014-01-07 |