| NPI | 1366834129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: KY 200122906) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: OH OH3021991) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2020-11-17 |