| NPI | 1336360247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 016536) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 016536) |
| 103TF0000X Psychologist Family (Licence: NY 016536) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2010-07-15 |