| NPI | 1811439656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NY P03892) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY P03892) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2016-11-10 |