| NPI | 1588716070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 018392) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 075839) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2010-06-17 |