| NPI | 1508279159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00517500) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 015153) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-06-10 |