| NPI | 1861677965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 017256) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 017256) |
| 103TS0200X Psychologist, School (Licence: NY 017256) | |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |