| NPI | 1558410183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY PR003047 1) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 107198) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2007-07-08 |