| NPI | 1821531815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 013206) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 9142) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2016-11-23 |