| NPI | 1912201336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9478) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6678) |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2015-08-04 |