| NPI | 1164713053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 003008) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 68018347) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2011-04-26 |