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 |