| NPI | 1548258692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NJ 35S100425700) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00425700) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2020-01-08 |