| NPI | 1235475344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 019808) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 019808) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 019808) | |
| 103TS0200X Psychologist School (Licence: NY 019808) | |
| 103TC0700X Psychologist Clinical (Licence: NY 019808) | |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2015-12-15 |