| NPI | 1225361421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 023368-01) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 081087-1) |
| 101YM0800X Counselor, Mental Health (Licence: NY 002281) | |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2019-10-23 |