| NPI | 1760479612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH 3297) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: OH 3297) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2011-02-03 |