NPI | 1215088554 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 6252) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1430) |
Enumeration Date | 2007-01-15 |
Last Update Date | 2007-07-08 |