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 |