| NPI | 1699106799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH P.07949) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810004893) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: VA 0810004893) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: VA 0810004893) | |
| Enumeration Date | 2013-11-29 |
| Last Update Date | 2019-11-25 |