| NPI | 1134575822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35SI00548100) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 021256-1) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |