| NPI | 1699898411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 015896) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 015896) |
| 103TS0200X Psychologist School (Licence: NY 015896) | |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2010-06-02 |