| NPI | 1700117173 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 020422-1)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R049618-1)  | 
| Enumeration Date | 2010-01-24 | 
| Last Update Date | 2014-03-17 |