| NPI | 1588191100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ 5779) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 022109) |
| 103TC0700X Psychologist Clinical (Licence: FL 9824) | |
| 103TF0200X Psychologist Forensic (Licence: FL 9824) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-08-25 |