| NPI | 1366558645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10906) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 5806) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2022-02-25 |