| NPI | 1154526507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 015659) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 015659) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 015659) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NY 015659) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: NY 015659) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: NY 015659) | |
| Enumeration Date | 2007-06-17 |
| Last Update Date | 2007-07-08 |