| NPI | 1669926606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 022956) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2019-01-03 |