| NPI | 1912211533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100280300) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 008318-1) |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2010-08-06 |