| NPI | 1982940318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VT 048.0000039) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 013631-1) |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2012-12-12 |