| NPI | 1174593552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 4020) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 1432) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2020-06-05 |