| NPI | 1962064592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.08152) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 11919) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2021-09-08 |