| NPI | 1467050641 |
|---|---|
| Former Name | JILL BOGARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100704700) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 026273) |
| Enumeration Date | 2020-10-11 |
| Last Update Date | 2024-02-10 |