| NPI | 1538598289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 1378866202) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2021-08-27 |