| NPI | 1447664479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 264783) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: Unlicensed) |
| 103T00000X Psychologist (Licence: KY PSYPAS00220824) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2024-08-01 |