| NPI | 1346633674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 174664) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 174664) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2021-08-05 |