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 |