| NPI | 1336306745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 129922) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 209) |
| 103TC0700X Psychologist, Clinical (Licence: NC 3345) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2017-11-15 |