NPI | 1780687731 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 010521-1) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 010521-1) |
103TF0000X Psychologist, Family (Licence: NY 010521-1) | |
103T00000X Psychologist (Licence: NY 010521-1) | |
Enumeration Date | 2005-05-23 |
Last Update Date | 2007-07-08 |