| NPI | 1841696119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: CT 002594) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NY 014978-1) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-13 |