| NPI | 1992771679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 5564) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: OH 5564) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2010-08-23 |