| NPI | 1548505514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH P.7079) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 7079) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS017296) | |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2024-02-01 |