| NPI | 1912995077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist (Licence: VA 0810003999) | |
| 103T00000X Psychologist (Licence: NY 018612) | |
| 103TC0700X Psychologist, Clinical (Licence: NY 018612) | |
| 103TF0200X Psychologist, Forensic | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2016-05-05 |