NPI | 1821370388 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 4930) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY NYS4930) |
Enumeration Date | 2011-09-12 |
Last Update Date | 2011-09-12 |