| NPI | 1700658713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS019977) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11856) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 35SI00695400) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS019977) | |
| 103TH0100X Psychologist, Health Service (Licence: MA 11856) | |
| 103TH0100X Psychologist, Health Service (Licence: NJ 35SI00695400) | |
| 103T00000X Psychologist (Licence: NJ 35SI00695400) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 11856) | |
| 103TH0100X Psychologist, Health Service (Licence: PA PS019977) | |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2023-10-23 |