| NPI | 1063472132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00510100) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 014931) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2019-03-05 |