| NPI | 1255787206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.08189) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 0000) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2021-08-25 |