| NPI | 1700274578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 35SI00539400) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 019400-1) |
| Enumeration Date | 2015-01-02 |
| Last Update Date | 2015-01-02 |