NPI | 1962653295 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 13974) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ permit # 083-914) |
Enumeration Date | 2008-10-06 |
Last Update Date | 2008-10-06 |