| NPI | 1386072726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY PSYLIP00212075) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 36293) |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2015-11-06 |