| NPI | 1902810328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 4412) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 4412) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 933731) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: OH 933731) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2017-02-05 |