| NPI | 1548696479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 125593) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IA 125593) |
| 103TC0700X Psychologist, Clinical (Licence: OH 7074) | |
| 103TC0700X Psychologist, Clinical (Licence: IA 125593) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IA 125593) | |
| 103TF0000X Psychologist, Family (Licence: IA 125593) | |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2024-08-08 |