| NPI | 1922213693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY12647) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 5958) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2025-08-25 |