| NPI | 1790707560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35S100133200) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 0064441) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |