| 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 |