| NPI | 1114204518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 019332) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 019332) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 019332) | |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2016-06-22 |