| NPI | 1487636981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS005119L) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100251800) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |