| NPI | 1083678684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH P6052) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP0932) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2008-06-05 |