| NPI | 1942284963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 1304) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 5899) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2010-09-09 |