| NPI | 1447871363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KY 268918) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: KY 251781) |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2021-02-10 |