| NPI | 1477913051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: NY 021528) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 021528) |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2016-02-25 |