| NPI | 1932515251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY 1773) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OH 7126) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2014-07-08 |