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 |