| NPI | 1508936717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 015684) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 015684) |
| 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00432100) | |
| 103T00000X Psychologist (Licence: NJ 35SI00432100) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |