| NPI | 1306997960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 015421) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 015421) |
| 103TF0000X Psychologist Family (Licence: NY 015421) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: NY 015421) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2013-10-18 |