| NPI | 1356495451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 6616) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 8054) |
| 103TC0700X Psychologist, Clinical (Licence: OH 6616) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2017-02-14 |