| NPI | 1942622147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 5134) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 019839) |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2014-01-08 |