| NPI | 1477674976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ SI3414) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ NC57415) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2007-07-08 |