NPI | 1578955092 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 008570-1) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 008570-1) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 008570-1) | |
Enumeration Date | 2015-02-19 |
Last Update Date | 2015-02-19 |