| NPI | 1265548218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NJ PC002201) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00094100) |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC00309200) | |
| 101YM0800X Counselor, Mental Health (Licence: NJ 37LC00094100) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2008-10-04 |