| 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 Mental Retardation & Developmental Disabilities (Licence: KY 1211) | |
| 103TC0700X Psychologist Clinical (Licence: GA 3225) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-08-29 |