| NPI | 1053523373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: NY 014232) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 014232) |
| 103TF0000X Psychologist Family (Licence: NY 014232) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2007-07-09 |