| NPI | 1649677311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 7233) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: OH 7233) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 7233) | |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2017-01-27 |