| NPI | 1649682766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 024303) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 05340) |
| 103TS0200X Psychologist, School (Licence: MD 05340) | |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2021-12-15 |