| NPI | 1356884290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: NJ 1046269) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: NY 898031141) |
| Enumeration Date | 2016-11-27 |
| Last Update Date | 2017-02-03 |