NPI | 1679013007 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS017613) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
103T00000X Psychologist (Licence: NJ 35SI00539600) | |
Enumeration Date | 2017-03-04 |
Last Update Date | 2019-12-13 |