NPI | 1104995703 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ S1003391) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 0124611) |
103TC0700X Psychologist, Clinical (Licence: IL 071007110) | |
Enumeration Date | 2006-11-07 |
Last Update Date | 2023-07-12 |