| NPI | 1316932049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 3423) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 399) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2007-07-08 |