| NPI | 1174606792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 0008) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: KY 0008) |
| 103T00000X Psychologist (Licence: KY 0008) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-08 |