| NPI | 1528498128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ LPC37PC00089300) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ LPC37PC00089300) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2020-04-01 |