| NPI | 1972761195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY P92114) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 001641-1) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2014-10-24 |