| NPI | 1902802960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 011208) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 002343) |
| 103TC0700X Psychologist, Clinical (Licence: PA PS-005601-L) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2009-08-04 |