| NPI | 1912047630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 5960) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TN 2766) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2021-04-29 |