NPI | 1164877551 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 021336) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 021336) |
103TR0400X Psychologist, Rehabilitation (Licence: NY 021336) | |
Enumeration Date | 2016-05-04 |
Last Update Date | 2021-01-13 |