NPI | 1124566617 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 5736) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NJ 5736) |
103TC0700X Psychologist, Clinical (Licence: NJ 5736) | |
Enumeration Date | 2017-02-06 |
Last Update Date | 2017-02-06 |