| NPI | 1659322949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 5320) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 10904) |
| 103TC0700X Psychologist, Clinical (Licence: VT 048.0106033) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2019-01-19 |