| NPI | 1174724389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ0042800) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00100600) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2018-03-17 |