| NPI | 1821095399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY003747) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NJ PSY003747) |
| 103T00000X Psychologist (Licence: NJ 35SI00313400) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2020-07-01 |