NPI | 1518177567 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 011617) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: NY 011617) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 011617) | |
103TF0000X Psychologist, Family (Licence: NY 011617) | |
Enumeration Date | 2007-05-22 |
Last Update Date | 2007-07-16 |