NPI | 1154432979 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 7049) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1211) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 1211) | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: KY 1211) | |
103TC0700X Psychologist, Clinical (Licence: GA 3225) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2013-08-29 |