| NPI | 1780707059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 001542) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 008618-1) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CT 001542) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CT 001542) | |
| 103TC0700X Psychologist, Clinical (Licence: CT 001542) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 001542) | |
| 103TF0000X Psychologist, Family (Licence: CT 001542) | |
| 103TH0100X Psychologist, Health Service (Licence: CT 001542) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2007-07-09 |