| NPI | 1124181060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH 6509) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MO 2006034886) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: KY 1290) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2009-01-09 |