| NPI | 1861792657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9224) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 018784-1) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2015-03-10 |