| NPI | 1649417015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 016679) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 016679) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2014-01-07 |