| NPI | 1619117579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 7963) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 4915) |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2015-02-24 |