| NPI | 1790904837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 008765-1) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NJ SI0-2296) |
| 103TH0004X Psychologist, Health (Licence: NY 008765-1) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |