| NPI | 1558677575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36838) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 7266) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2017-03-27 |