| NPI | 1376642033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 245346) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 0809) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-01-27 |