| NPI | 1902072259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 010994-2) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 010994-2) |
| 103TC0700X Psychologist, Clinical (Licence: NY 010994-2) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 010994-2) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-05-07 |