| NPI | 1366877391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 020254) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NY 020254) |
| 103TC1900X Psychologist, Counseling (Licence: NY 020254) | |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2019-09-03 |