| NPI | 1083956924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS LCP 086 (BSRB)) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: KS 1572833211 (KSDE)) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2013-03-18 |