| NPI | 1447579883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 130711) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 1589) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2020-11-09 |