| NPI | 1689808883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 8417) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6543) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2022-04-06 |