| NPI | 1699143362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 020432) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 020432) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |