| NPI | 1164631313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35S100385300) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NJ 35SI00385300) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 35SI00385300) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NJ 35SI00385300) | |
| 103TS0200X Psychologist, School (Licence: NJ 35SI00385300) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2010-02-02 |