NPI | 1235438193 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 013061) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 013061) |
103TS0200X Psychologist, School (Licence: NY 013061) | |
Enumeration Date | 2011-03-17 |
Last Update Date | 2011-03-17 |