| NPI | 1366178295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 020774-01) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NY 020774-01) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 020774-01) | |
| 103TC1900X Psychologist, Counseling (Licence: NY 020774-01) | |
| 103TE1100X Psychologist, Exercise & Sports (Licence: NY 020774-01) | |
| 103TH0100X Psychologist, Health Service (Licence: NY 020774-01) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NY 020774-01) | |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2022-07-25 |