| NPI | 1023744190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35S100586500) |
| Additional Taxonomies | 101YS0200X Counselor School |
| 103T00000X Psychologist (Licence: NY 022414) | |
| 103TS0200X Psychologist School | |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2022-07-29 |