| NPI | 1164856639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH P08149) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103T00000X Psychologist (Licence: PA PS018569) | |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2021-05-04 |