| NPI | 1619340494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00543300) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS017692) |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2015-11-03 |