| NPI | 1023393519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ 5346) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS017592) |
| 103TC0700X Psychologist Clinical (Licence: NY 020697) | |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2015-07-01 |