NPI | 1871564823 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 015987) |
Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 015987) |
Enumeration Date | 2006-01-29 |
Last Update Date | 2007-07-08 |