| NPI | 1699864033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 012344) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 012344) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 012344) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2009-08-25 |