| NPI | 1760685549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 68 019065) |
| Additional Taxonomies | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2011-04-25 |