NPI | 1639239361 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 009237-1) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ SI 02150) |
Enumeration Date | 2006-12-11 |
Last Update Date | 2019-10-08 |