NPI | 1639211618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 3968) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 022536) |
103TC2200X Psychologist Clinical Child & Adolescent (Licence: AZ 3968) | |
103TB0200X Psychologist Cognitive & Behavioral (Licence: AZ 3968) | |
103TB0200X Psychologist Cognitive & Behavioral (Licence: NY 022536) | |
103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 022536) | |
103TH0004X Psychologist Health (Licence: AZ 3968) | |
Enumeration Date | 2007-02-13 |
Last Update Date | 2024-09-09 |