| NPI | 1023141009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 6106) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 015165) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2013-01-09 |