| NPI | 1548633506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 016100) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 51930) |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2015-11-12 |