| NPI | 1902458029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 023256) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 023256) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 023256) | |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2021-01-11 |