NPI | 1558770644 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 020018) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 5127) |
Enumeration Date | 2014-08-04 |
Last Update Date | 2014-08-04 |