| NPI | 1982939104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5917) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 6421) |
| 103T00000X Psychologist (Licence: NC 4735) | |
| 103TC0700X Psychologist, Clinical (Licence: NY 024245-01) | |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2023-11-14 |