| NPI | 1861772618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 023635) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TH0004X Psychologist, Health | |
| 103TH0100X Psychologist, Health Service (Licence: NJ 35SI00725600) | |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2025-08-06 |