| NPI | 1912250689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH 6740) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 018781) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2015-05-18 |