| NPI | 1639128119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 1322) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 6046) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-07-08 |