| NPI | 1366564601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 001428) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: NY 001428) |
| 103TC1900X Psychologist Counseling (Licence: NY 001428) | |
| 103TP0814X Psychologist Psychoanalysis (Licence: NY 001428) | |
| 103TS0200X Psychologist School (Licence: NY 001428) | |
| 106H00000X Marriage & Family Therapist (Licence: NJ 37F100122000) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-08-30 |