| NPI | 1255068961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: KY 201227983) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: OH OH3285639) |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2022-08-03 |