| NPI | 1861463804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 7526) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 014133) |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2019-12-10 |