| NPI | 1255309530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 78519) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 361) |
| 106H00000X Marriage & Family Therapist (Licence: KY 0308) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2007-07-08 |