NPI | 1518926682 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 061-A307) |
Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: LA 343885) |
103TC0700X Psychologist, Clinical (Licence: CA 19650) | |
Enumeration Date | 2006-03-18 |
Last Update Date | 2025-10-02 |