| NPI | 1144565888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 129374) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: KY 129374) |
| 103TS0200X Psychologist, School (Licence: KY 1753) | |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2017-07-05 |