NPI | 1417414400 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ NJDCATEMP-024757) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810006112) |
Enumeration Date | 2019-02-26 |
Last Update Date | 2020-09-06 |