| NPI | 1558770644 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 020018)  | 
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 5127)  | 
| Enumeration Date | 2014-08-04 | 
| Last Update Date | 2014-08-04 |