| NPI | 1972641546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY NY018217) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MA 11793) |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2024-07-19 |