| NPI | 1710185558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 016315) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NY 016315) |
| 103TC0700X Psychologist Clinical (Licence: NY 016315) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2018-03-17 |