| NPI | 1336219955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 10483) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 10483) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 017234) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2024-06-26 |