| NPI | 1629308507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS018052) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01161) |
| 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00557800) | |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2018-01-15 |