| NPI | 1306405832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100245300) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 00915-1) |
| Enumeration Date | 2019-06-09 |
| Last Update Date | 2019-06-09 |