| NPI | 1245558394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 017623-1) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 017623-1) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2018-12-18 |