| NPI | 1790021384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH P.07787) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC0006509) |
| Enumeration Date | 2012-12-31 |
| Last Update Date | 2018-09-20 |