NPI | 1578038105 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NY 022102-01) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 022102-1) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 022102-1) | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 022102-1) | |
103TS0200X Psychologist, School (Licence: NY 022102-1) | |
Enumeration Date | 2018-10-10 |
Last Update Date | 2018-10-10 |