| NPI | 1962698480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 015388) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 015388) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 015388) | |
| 103TF0000X Psychologist, Family (Licence: NY 015388) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NY 015388) | |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2019-12-26 |