| NPI | 1194855981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NY 000411) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AZ 4045) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: AZ 4045) | |
| 103TS0200X Psychologist School | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: AZ 4045) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2010-10-18 |