| NPI | 1083922603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS T55974) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6715) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2015-12-23 |