| NPI | 1154618635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 019721) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: NY 1875262) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2015-09-18 |