| NPI | 1982896734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016228) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 015415) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2007-08-15 |