| NPI | 1508088667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 009723) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 009723) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 009723) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2018-02-23 |