| NPI | 1306061577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 015537) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: NY 015537) |
| 103TA0700X Psychologist Adult Development & Aging (Licence: NY 015537) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: NY 015537) | |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2008-04-24 |