| NPI | 1710352588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS017343) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NJ 35S100553900) |
| 103TF0000X Psychologist Family (Licence: NJ 35S100223900) | |
| 103TF0000X Psychologist Family (Licence: PA PS017343) | |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2016-01-28 |