| NPI | 1811179534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7547) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 017267) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2007-12-04 |