| NPI | 1174897854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 022230-1) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: NY 530023111) |
| 103TS0200X Psychologist, School (Licence: NY 533364111) | |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2019-05-28 |