| NPI | 1629228077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 018981) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 018981) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2013-10-07 |