| NPI | 1386662773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 129124) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WV 1378) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-05-14 |