| NPI | 1518090844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 8275) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 8275) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 8275) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: NY 8275) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2007-07-08 |