| NPI | 1598980641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS005728L) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 35S100374700) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PA PS0005728L) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PA Ps00005728L) | |
| 103TF0200X Psychologist, Forensic (Licence: PA ps005728l) | |
| 103T00000X Psychologist (Licence: PA ps0005728l) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2017-03-21 |