| NPI | 1982679403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH 3898) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: OH 3898) |
| 103T00000X Psychologist (Licence: OH 3898) | |
| Enumeration Date | 2006-02-19 |
| Last Update Date | 2012-08-13 |