| NPI | 1902006307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003095) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 017582) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2008-12-22 |