| NPI | 1982107025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 022586) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 022586) |
| 103TF0000X Psychologist Family (Licence: NY 022586) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: NY 022586) | |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |