| NPI | 1215331616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: OH SP00630) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: OH OH1342953) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2021-04-05 |