| NPI | 1619306669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS-009168-L) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100426200) |
| Enumeration Date | 2013-11-09 |
| Last Update Date | 2014-09-18 |