| NPI | 1861947822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH 6592) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OH 6592) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2023-03-22 |