| NPI | 1174072870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 021507) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 021507) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NY 021507) | |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-10-13 |