| NPI | 1245351816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 015911) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 015911-1) |
| 103TF0000X Psychologist Family (Licence: NY 015911-1) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: NY 015911-1) | |
| 103TS0200X Psychologist School (Licence: NY 015911-1) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2016-12-08 |