NPI | 1104288307 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00556700) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 021467) |
Enumeration Date | 2016-03-26 |
Last Update Date | 2022-01-11 |