NPI | 1073792503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 016671-1) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 016671-1) |
Enumeration Date | 2007-11-01 |
Last Update Date | 2022-01-07 |