| NPI | 1568022119 |
|---|---|
| Former Name | CLARISSA LYNN MOONEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 022254) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 022254) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2024-05-29 |