| NPI | 1699873794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 016600-1) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 6203) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-12-13 |