| NPI | 1184836892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY7133) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NJ 35S100346000) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2009-02-25 |