NPI | 1104272517 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00558200) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 35SI00558200) |
Enumeration Date | 2016-05-05 |
Last Update Date | 2016-05-05 |