NPI | 1417238544 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 021970) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 021970) |
Enumeration Date | 2011-09-02 |
Last Update Date | 2017-03-10 |