| NPI | 1831340009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 019070) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CT 003354) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2015-10-14 |