| NPI | 1083794614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY PSYPST00218953) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OH 6288) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2015-07-31 |