| NPI | 1114322120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY KY-1246) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: KY Ky-1246) |
| 103TC1900X Psychologist, Counseling (Licence: KY Ky-1246) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: KY Ky-1246) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: KY Ky-1246) | |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2014-11-03 |