| NPI | 1205814639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 128195) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: KY 0777) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 0777) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2020-10-23 |