| NPI | 1740666882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 02112) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 02112) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 02112) | |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2015-07-30 |