NPI | 1558894501 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100589100) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NJ 35S100589100) |
103TF0000X Psychologist, Family (Licence: PA PS018256) | |
Enumeration Date | 2017-04-06 |
Last Update Date | 2018-11-02 |