| NPI | 1851689491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 7511) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 1397) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2016-12-06 |