NPI | 1235711466 |
---|---|
Former Name | SAMANTHA REINA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00636900) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 023970-01) |
Enumeration Date | 2021-04-27 |
Last Update Date | 2021-04-27 |