| NPI | 1225202419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY KY0689) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY KY1044) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2008-04-17 |