| 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 |