| NPI | 1104879758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 013949) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 013949) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2021-01-07 |