| NPI | 1477616670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 0131282) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NJ 4362) |
| 103T00000X Psychologist (Licence: NY 0132182) | |
| 103TH0100X Psychologist Health Service (Licence: NJ 4362) | |
| 103TR0400X Psychologist Rehabilitation (Licence: NJ 4362) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-07-17 |