| NPI | 1134536568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OH P.7157) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OH 7157) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2024-04-02 |