| NPI | 1720093651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04527) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 3736) |
| 103TC0700X Psychologist, Clinical (Licence: OH 6240) | |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2024-02-06 |