| NPI | 1558794545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH 6516) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OH 6516) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2022-02-23 |