| NPI | 1841561065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 010674-1) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 1675) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2016-01-23 |