| NPI | 1255488151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ 3981) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS008967L) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2015-04-15 |