NPI | 1992100028 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: SC 1335) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NJ 03378) |
Enumeration Date | 2014-10-31 |
Last Update Date | 2022-08-09 |