NPI | 1053794271 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 021175) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 021175) |
Enumeration Date | 2015-07-07 |
Last Update Date | 2021-01-11 |