| 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 |