| NPI | 1801247408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 021650) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NY 021650) |
| 103TC0700X Psychologist Clinical (Licence: NY 021650) | |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2016-06-24 |