| NPI | 1295163665 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 022035)  | 
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities | 
| 283Q00000X Psychiatric Hospital | |
| Enumeration Date | 2013-10-23 | 
| Last Update Date | 2019-03-28 |