NPI | 1114324407 |
---|---|
Former Name | CAROLINE PIERPONT KOTONIAS-PAYNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: NY 018865) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 018865) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 018865) | |
Enumeration Date | 2014-12-02 |
Last Update Date | 2014-12-02 |