| NPI | 1265971683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.07753) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH P.07753) |
| 103TC0700X Psychologist, Clinical (Licence: KS 2492) | |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2019-02-12 |