| NPI | 1972552602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH 6225) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: OH 841186) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2007-07-08 |