| NPI | 1962879536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 018574-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 018574-1) |
| Enumeration Date | 2015-08-30 |
| Last Update Date | 2015-08-30 |