| NPI | 1275106411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 273223) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 245817) |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2024-06-06 |