| NPI | 1164209664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: PA 3142531) |
| 103TS0200X Psychologist, School (Licence: OH 3233341) | |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-09-11 |