| NPI | 1134509979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 020515) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NJ 35SI00534200) |
| Enumeration Date | 2015-06-07 |
| Last Update Date | 2021-05-17 |