| 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 |