NPI | 1093024283 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 020024-1) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 020024) |
Enumeration Date | 2010-10-05 |
Last Update Date | 2013-10-01 |