| NPI | 1770925778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 68 020026) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 68 020026) |
| 103TC0700X Psychologist, Clinical (Licence: CT 003302) | |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2013-09-18 |