NPI | 1265742183 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 018881) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY 9165) |
Enumeration Date | 2010-10-13 |
Last Update Date | 2020-04-10 |