| NPI | 1154453231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH 6891) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CO 3681) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2019-10-11 |