| NPI | 1457307290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY KY90) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY KY0418) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2011-06-14 |