| NPI | 1619518560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11198) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 7472) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2022-02-28 |