| NPI | 1295191799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ 5316) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 020198) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |