| NPI | 1629212410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00599800) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 9674) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2018-12-17 |