NPI | 1235291030 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: NY 013707) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 013707) |
103TF0200X Psychologist, Forensic (Licence: NY 013707) | |
103T00000X Psychologist (Licence: NY 013707) | |
Enumeration Date | 2006-12-15 |
Last Update Date | 2007-07-08 |