| NPI | 1225605819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH P.08146) |
| Additional Taxonomies | 103TH0004X Psychologist Health |
| 103TH0100X Psychologist Health Service | |
| 103T00000X Psychologist | |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2021-06-10 |