| NPI | 1083856801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 172703) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 0844) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2023-09-19 |