| NPI | 1245641547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 130473) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004987) |
| 103TC0700X Psychologist, Clinical (Licence: KY 1779) | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2022-11-28 |