| 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 |