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 |