| NPI | 1437250602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 0822) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: KY 0822) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: KY 0822) | |
| 103TC0700X Psychologist, Clinical (Licence: KY 0822) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 0822) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2025-09-11 |