| NPI | 1477266963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH P.08424) |
| Additional Taxonomies | 103TE1100X Psychologist Exercise & Sports |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2022-12-30 |