| NPI | 1336703149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 280638) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 280638) |
| 103TC0700X Psychologist, Clinical (Licence: KY 273222) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: KY 273222) | |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2022-10-19 |