| NPI | 1265545131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 171016) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 0151) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2017-04-13 |