| NPI | 1619951951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS002319L) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI003348) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2007-07-09 |