| NPI | 1548896947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.08421) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 3151) |
| 103T00000X Psychologist (Licence: TX 37954) | |
| 103TC0700X Psychologist, Clinical (Licence: OH P.08421) | |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2025-02-19 |