NPI | 1619348992 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.07914) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OH 128-140) |
Enumeration Date | 2015-10-13 |
Last Update Date | 2020-03-20 |