| NPI | 1679624001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00411100) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 01538) |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2007-07-08 |