NPI | 1003005638 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 013801-1) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 013801-1) |
Enumeration Date | 2007-10-19 |
Last Update Date | 2012-01-04 |