| NPI | 1487676300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 015671-1) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: NY 015671-1) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 015671-1) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |