NPI | 1649490533 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS003978L) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NJ 35SI00211200) |
103TA0700X Psychologist, Adult Development & Aging | |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TC0700X Psychologist, Clinical (Licence: PA PS003978L) | |
103TC0700X Psychologist, Clinical (Licence: NJ 35S100211200) | |
103TC2200X Psychologist, Clinical Child & Adolescent | |
103TF0000X Psychologist, Family | |
Enumeration Date | 2007-04-26 |
Last Update Date | 2007-07-08 |