| NPI | 1639452758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 7497) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: CA 31074) | |
| Enumeration Date | 2011-09-25 |
| Last Update Date | 2023-03-06 |