| NPI | 1285911719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 1749) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 1749) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: KY 1749) | |
| 103TC1900X Psychologist, Counseling (Licence: KY 1749) | |
| 103TF0000X Psychologist, Family (Licence: KY 1749) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: KY 1749) | |
| 103TH0004X Psychologist, Health (Licence: KY 1749) | |
| Enumeration Date | 2011-11-11 |
| Last Update Date | 2014-04-10 |