| 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 |