NPI | 1891091435 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 018290) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 018290) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 018290) | |
Enumeration Date | 2011-01-30 |
Last Update Date | 2015-09-18 |