| NPI | 1841326196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 017997) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810003774) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2019-09-05 |