| NPI | 1063863801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 00007158) |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 103T00000X Psychologist (Licence: NY 00007158) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 00007158) | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |