| NPI | 1629097423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ SI01619) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 6789) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2010-09-10 |