| NPI | 1063759892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ 35S100291100) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WI 3961) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2025-08-24 |