NPI | 1356708838 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 243586) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY PSYPST00224030) |
Enumeration Date | 2016-01-28 |
Last Update Date | 2023-07-10 |