| NPI | 1578955092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TM1800X Psychologist Mental Retardation & 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 |