| NPI | 1356589360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NM 1277) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.0600552) |
| 101YM0800X Counselor, Mental Health (Licence: MO 2009001340) | |
| 103TC0700X Psychologist, Clinical (Licence: AR 18-11P) | |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2020-06-03 |