| NPI | 1548873193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 024523) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY P106096) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY P106096) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 024523) | |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2022-01-19 |