| NPI | 1063567717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 013297) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 013297) |
| 103T00000X Psychologist (Licence: 013297) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2015-02-10 |