| NPI | 1386662773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 1452) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY TEMP-2005-65) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-12-22 |