| NPI | 1790117836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OH P.7054) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OH 7054) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2021-10-10 |