| NPI | 1962811257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35s100526600) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 020110-1) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 35s100526600) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 020110-1) | |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2014-08-12 |