| NPI | 1316906100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 1600) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 5905) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-02-19 |