| NPI | 1316511249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 024120) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NY 024120) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 024120) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 024120) | |
| Enumeration Date | 2021-05-15 |
| Last Update Date | 2021-05-15 |