| NPI | 1154788719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00554600) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 020505) |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2017-02-17 |