| NPI | 1164514212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.7026) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1252) |
| 103TC0700X Psychologist, Clinical (Licence: OH 7026) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2021-02-12 |