| NPI | 1003282559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY PSYPAT 00218866) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 166069) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2021-06-14 |