| NPI | 1972913648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 4828) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OH 3196) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2016-08-13 |