| NPI | 1760545669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: OH 4122) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 4122) |
| 103TC1900X Psychologist Counseling (Licence: OH 4122) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OH 4122) | |
| 103TF0000X Psychologist Family (Licence: OH 4122) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-07-09 |