NPI | 1831435635 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 68019701) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 68019701) |
Enumeration Date | 2012-12-25 |
Last Update Date | 2012-12-25 |