| NPI | 1578774212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ 2665) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 010337) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2007-07-08 |