NPI | 1902097785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 015707) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: CT 002561) |
103TC0700X Psychologist, Clinical (Licence: CT 002561) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 002561) | |
Enumeration Date | 2007-08-06 |
Last Update Date | 2014-07-30 |