| NPI | 1275542706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 014454-1) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 000810) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 000810) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-08 |