NPI | 1184709412 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00401400) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 35S100401400) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 35SI00401400) | |
Enumeration Date | 2006-10-26 |
Last Update Date | 2018-05-03 |