| NPI | 1861917163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH P07893) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2022-06-02 |