| NPI | 1659796597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00492400) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS016906) |
| Enumeration Date | 2014-03-02 |
| Last Update Date | 2018-12-03 |