| NPI | 1912191008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 017288) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NY 017288) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2007-08-31 |