| NPI | 1609082452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 016789) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 016789) |
| 103TC0700X Psychologist, Clinical (Licence: NY 016789) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2015-12-17 |