NPI | 1003265414 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 025690) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NY 001161-1) |
221700000X Art Therapist (Licence: NY 001161-1) | |
246ZA2600X Specialist/Technologist, Other, Art, Medical (Licence: NY 001161-1) | |
Enumeration Date | 2016-06-07 |
Last Update Date | 2023-05-19 |