| NPI | 1043435720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 014201-1) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 014201-1) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2021-06-04 |