NPI | 1437464880 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 017055) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NY 017055) |
103TP2701X Psychologist, Group Psychotherapy (Licence: NY 017055) | |
Enumeration Date | 2010-08-10 |
Last Update Date | 2010-08-25 |