| 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 |