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 | 2024-08-08 |