| NPI | 1518383090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 7292) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 7292) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OH 7292) | |
| Enumeration Date | 2014-03-08 |
| Last Update Date | 2015-12-04 |