| NPI | 1609064286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH 5026) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 1452) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AL 1452) | |
| 103T00000X Psychologist (Licence: AL 1452) | |
| 103TC0700X Psychologist, Clinical (Licence: OH 5026) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 5026) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2014-01-28 |