| 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 |