| NPI | 1154582500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: NJ 25MA09158700) |
| 208D00000X General Practice (Licence: NJ 25MA09158700) | |
| 102L00000X Psychoanalyst (Licence: NJ 25MA09158700) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2013-11-06 |