| NPI | 1770530602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 5973) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 5973) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2023-11-15 |