NPI | 1114082252 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 68-014278) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 68-014278) |
103T00000X Psychologist (Licence: NY 68-014278) | |
Enumeration Date | 2006-12-27 |
Last Update Date | 2018-06-07 |