| NPI | 1790979250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 6743) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DE B10000771) |
| 103TC0700X Psychologist, Clinical (Licence: PA PS016538) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2011-01-06 |