| NPI | 1659668754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35S100158600) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 005712-1) |
| Enumeration Date | 2011-07-09 |
| Last Update Date | 2011-07-09 |