| NPI | 1255542593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35S100405700) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 0131201) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2013-11-07 |