| NPI | 1154463297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 4293) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 4293) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: OH 4293) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-10-21 |