| NPI | 1518477462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: 022336) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: 022336) |
| 103T00000X Psychologist (Licence: NY 022336) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 022336) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: NY 022336) | |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2017-10-05 |