| NPI | 1679801278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 749) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6843) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2020-11-12 |