| NPI | 1104654813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ 35SI00748100) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 025325) |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-10-10 |