| NPI | 1891062550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 010085) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 010085-1) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2020-09-29 |