| NPI | 1700511417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ 6742) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS019587) |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2022-07-18 |