NPI | 1548447030 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 5360) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 1240) |
Enumeration Date | 2008-01-28 |
Last Update Date | 2008-01-28 |