| NPI | 1972616027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY5424) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY5424) |
| 103TC0700X Psychologist, Clinical (Licence: NY 012418) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2019-04-05 |