| NPI | 1508821075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: OH 7435) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY6057) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2016-09-12 |