| NPI | 1366648370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL 7961) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 017781) |
| 282N00000X General Acute Care Hospital (Licence: NY 017781) | |
| 103TF0200X Psychologist Forensic (Licence: FL 7961) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: FL 7961) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL 7961) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2010-04-20 |