| NPI | 1619264785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 003599) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 019706) |
| 103T00000X Psychologist (Licence: NY 019706) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: NY 019706) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 019706) | |
| 103TC0700X Psychologist, Clinical (Licence: NY 019706) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: NY 019706) | |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2019-08-01 |