NPI | 1578771499 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 103228-1) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: NY 103228-1) |
Enumeration Date | 2007-05-21 |
Last Update Date | 2007-07-08 |