| NPI | 1235264334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 014474.1) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: NY 014474.1) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-07-08 |