NPI | 1306390620 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 022434) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
Enumeration Date | 2016-08-04 |
Last Update Date | 2018-03-17 |