| NPI | 1316256571 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 130480)  | 
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: KY KY-2010-75)  | 
| Enumeration Date | 2010-10-05 | 
| Last Update Date | 2023-09-08 |