NPI | 1568795748 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 017297) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 017297) |
103TA0700X Psychologist, Adult Development & Aging (Licence: NY 017297) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 017297) | |
Enumeration Date | 2009-09-07 |
Last Update Date | 2009-09-07 |