| NPI | 1134330574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY KY1601) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810003638) |
| 103TC0700X Psychologist, Clinical (Licence: KY 1601) | |
| 103TC0700X Psychologist, Clinical (Licence: MT 324) | |
| 103TC0700X Psychologist, Clinical (Licence: CO 2472) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2019-08-19 |