| NPI | 1790823664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NJ 5103005) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NJ 8103005) |
| 103T00000X Psychologist (Licence: NJ 5103005) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |